Objective: To rationally reduce the fees and improve the development of large public hospitals. Methods: Analyze the relationship among the fees, hospital economic activity and medical treatment price mechanism in large public hospitals based on resource dependence theory. Results: Price control can not effectively control the costs. Conclusion: Medical price mechanism reform should in the direction of medical system reform, avoid the “quantity success” in large public hospitals, strive for patients with basic medical health institutions; then it should adequately embodies the value of technical work value of medical project and stimulates the initiative of the doctor.

The present paper reviewed the recent researches on the toxicity and health effect of phthalate in the following four aspects: animal toxicology, population epidemiology, people exposure, and safety standard, moreover, some critical problems which should be studied as soon as possible were proposed.

ObjectiveTo introduce a rapid and stable rat model of middle cerebral artery occlusion (MCAO). Methods32 Wistar male rats were used to induce focal cerebral ischemia according to Longa's method. The main difference from Longa's was to introduce a nylon suture into the cervical internal carotid artery without ligation the pterygopalatine artery (PPA). Regional cerebral blood flow (rCBF), neurological deficit, brain water content, red tetrzolium (TTC) stain and pathology were evaluated in all rats.ResultsThe operation proceeded about 15 min after anaesthesia. Rats after operation presented severe neurological deficits companied with rCBF decreases. There were significant increases of brain water contents in ischemic brain regions. TTC staining showed infarct areas and histological examinations revealed remarkable astrocyte swelling and neuronal necrosis.ConclusionInducing rat MCAO without ligation of PPA could produce reliable ischemic changes,with the advantage of shortening operation time.

Objective To evaluate the significance of the treatment of intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop. Methods The authors respectively analyzed 24 cases of intra- or extra- hepatic recurrent stones and/or acute cholangitis treated through the subcutaneous jejunal loop from January 1989 to January 2003. Results Of the 24 cases, 10 cases (18 times) of acute cholangitis received drainage through the subcutaneous jejunal loop and their symptoms relieved (18/18); 14 cases (17 times) of recurrent intra- and extra- hepatic stones received selective drainage placement through the subcutaneous jejunal loop. The extra- or intra- hepatic stones were removed under choledochoscope through the subcutaneous jejunal loop, the stone clearance rate being 79.2% (19/24). Conclusions It is a convenient, minimally invasive, and effective method to treat intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop.

To study the determination method of cholesterol in human serum by Coulometric titration. METHODS: The titration was carried out in an electrolytic solution containing 1 mol.L-1 potassium bromide and glacial acetic acid (1∶3). Bromine was electrogenerated at the anode and cholesterol reacted with bromine with a value of reactional electrons (n) as 2. RESULTS: The ranges of recovery for 0.115 mg to 0.459 mg of cholesterol were from 93.9% to 105%, and the average recovery was 100.3%. The relative standard deviation in all applied analysis was less than 1.5%. The accuracy of the method was also assessed in comparison with the results obtained by the enzymatic method used clinically. CONCLUSION: The method proposed is simple, rapid and accurate, and is suitable for the determination of cholesterol in human serum samples.

Objective:To evaluate the safety of patient controlled epidural analgesia (PCEA)for elderly patient. Method: Forty two adult patients after operation were divided into control group(44.4?7.8a)and old group(70.9?5.la) according to their ages. All patients reeeived epidural 0.125% bupivacaine and 0.01% morphine mixture for PCEA. BP,HR, RR and SpO_2 were monitored for the first 24 hours following PCEA. Result: The dosage of the mixture was 33.3?6.8ml in control group and 31.6?8.7ml in old group. BP,HR didn't alter markedly in both groups throughout the whole period. RR and SpO_2 remined normal levels. Conclusion: With adequate dosage PCEA can be used safely for elderly postoperative analgesia

Objective To explore the preliminary experience of combined liver-kidney transplantation.Methods Twelve patients were subjected to combined liver-kidney transplantation. The orthotopic liver transplantation was preceded with the classic fashion in 8 patients and the piggyback fashion in 4 patients. The pump-driven veuovenoas bypass technique was not used. And then the kidney transplantation was performed under stable homodynamic circumstance. The renal graft was implanted to the right iliac fossa routinely. The renal vein was anastomosed to the external iliac rein end-to-side, and the renal artery to the external iliac artery end-to-side or the hypogastric artery end-to-end. After operation, anti-CD25 monoclonal antibody or antithymocyte globulin (ATG), tacrolimus (FK506), mycophenolate mofetil and prednisone were used to prevent the allograft rejection.Results The survival rate of the 12 cases receiving combined liver-kidney transplantation was 100 %, and the graft function was restored well postoperation. An acute rejection episode of liver occurred in one patient. The FK506 toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pneumonia occurred in one case and the peritoneal infection in one patient. No patient experienced any episode of acute rejection of renal allograft.Conclusions The combined liver-kidney transplantation is the ideal option of patients with end-stage liver disease with chronic renal failure.

Objective To investigate the effect of different pharmacotherapy after lacrimal passage plastic laser operation. Methods Divided 90 patients (103 eyes) with nasolacrimal duct obstruction into group A (33 eyes), group B (36 eyes) and group C (34 eyes) randomly, each group consisted of 30 cases. Tetracycline cortisone ophthalmic ointment (TCO) was used to perfuse lacrimal duct in the end of the operation in group A, while TDO was used in group B and group C. In the first three postoperative irrigation, TDO was used only in group C, there are no no ointment during the course of irrigation in the other two groups. Followed-up survey for 3 months, evaluated the efficacy of the treatment in 3 groups. Results The therapeutic efficacy was significant better in group B than in group A (P

Objective To evaluate the best experimental technique with high-sensitivity and specificity for enhancing positive rate of syphilis screen test and preventing the blood dissemination of this disease.Methods Comparison of the results of TP-ELISA,TRUST and TPPA methods of syphilis examination was performed.Results Using three methods to exam 43,323 samples,299 samples were for positive syphilis.Among them, 294 positive samples with the ELISA method,the positive rate of syphilis test was 98.33%(294/299):92 positive samples with TRUST method,the positive rate only 30.77%(92/299);239 positive samples with TPPA method,the positive rate 79.93%(239/299).Conclusion TP-ELISA method with high sensitivity is suitable for the instrument standardization and data preservation,which is an ideal method for blood screen test of syphilis.For guarantee of blood safety and conventience and economic benefit of blood syphilis screen test, it is the best way to use both TP-ELISA and TRUST methods.The specificity of TPPA method is perfect, which is suitable for confirmation test of syphilis positive samples.

The projections from the nuclei of the brain stem to the cerebellar nuclei were studied with the horse-radish peroxidase (HRP) retrograde transport method. The following nuclei in the brain stem were labelled with HRP;the inferior olivary nucleus, the lateral reticular nucleus, the nucleus reticularis tegmenti pontis, the pontine nuclei, the spinal trigeminal nucleus, the principal sensory trigeminal nucleus, the mesencephalic nucleus of trigeminal nerve, the spinal vestibular nucleus, the medial vestibular nucleus, the nucleus reticularis medullae .oblongatae pars ventralis, the nucleus reticularis gigantocellularis, the nucleus reticularis paramedianus, the raphe nucleus pontis, the raphe nucleus obscurus, the raphe nucleus magnus, the perihypoglossal nucleus, the locus caeruleus, the gracile nucleus, the cuneate nucleus, and the external cuneate nucleus.It was found that there are different patterns for the cerebellar nuclei to receive the afferent fibers from the brain stem. The number of the labelled nuclei of the brain stem projecting to the cerebellar lateral nucleus is similar to that projecting to the interpositate nucleus, while the number of the labelled brain stem nuclei projecting to the cerebellar fastigial nucleus is smaller than the above two. The topographic organization of the projections from the inferior olivary nucleus to the cerebellar nuclei was discussed.